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Triangular Resection of the Upper Lateral Cartilage for Middle Vault Deviation

  • Ryu, Gwanghui;Seo, Min Young;Lee, Kyung Eun;Hong, Sang Duk;Chung, Seung-Kyu;Dhong, Hun-Jong;Kim, Hyo Yeol
    • Clinical and Experimental Otorhinolaryngology
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    • v.11 no.4
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    • pp.275-280
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    • 2018
  • Objectives. Middle vault deviation has a significant effect on the aesthetic and functional aspects of the nose, and its management continues to be a challenge. Spreader graft and its modification techniques have been focused, but there has been scarce consideration for removing surplus portion and balancing the upper lateral cartilage (ULC). This study aimed to report the newly invented triangular-shaped resection technique ("triangular resection") of the ULC and to evaluate its efficacy for correcting middle vault deviation. Methods. A retrospective study included 17 consecutive patients who presented with middle vault deviation and underwent septorhinoplasty by using triangular resection at a tertiary academic hospital from February 2014 and March 2016. Their outcomes were evaluated pre- and postoperatively including medical photographs, acoustic rhinometry and subjective nasal obstruction using a 7-point Likert scale. Results. The immediate outcomes were evaluated around 1 month after surgery, and long-term outcomes were available in 12 patients; the mean follow-up period was 9.1 months. Nasal tip deviation angle was reduced from $5.66^{\circ}$ to $2.37^{\circ}$ immediately (P<0.001). Middle vault deviation also improved from $169.50^{\circ}$ to $177.24^{\circ}$ (P<0.001). Long-term results were $2.49^{\circ}$ (P=0.015) for nasal tip deviation and $178.68^{\circ}$ (P=0.002) for middle vault deviation. The aesthetic outcome involved a complete correction in eight patients (47.1%), a minimally visible deviation in seven patients (41.2%) and a remaining residual deviation in two patients (11.8%). Pre- and postoperative minimal cross-sectional areas (summation of the right and left sides) were 0.86 and 1.07, respectively (P=0.021). Fifteen patients answered about their nasal obstruction symptoms and the median symptom score had alleviated from 6.0 to 3.0 (P=0.004). Conclusion. Triangular resection of the ULC is a simple and effective method for correcting middle vault deviation and balancing the ULCs without complications as internal nasal valve narrowing.

The Overlapping Running Suture Method Using Single Knotless Barbed Absorbable Suture Material for Abdominal Wall Closure after Single Incision Laparoscopic Appendectomy: Comparison with the Traditional Interrupted Closure Technique

  • Kim, Dong Hyun;Park, Jung Ho;Joo, Jung Il;Jeon, Jang Yong;Lim, Sang Woo
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.160-167
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    • 2018
  • Purpose: The aim of our study was to present an abdominal wall closure technique using barbed suture $V-Loc^{TM}$ 90 after single incision laparoscopic appendectomy (SILA) and to compare perioperative outcomes with conventional layer by layer abdominal wall closure after SILA. Methods: From March 2014 to July 2016, a retrospective case-control study was conducted for a total of 269 consecutive patients who underwent SILA. According to abdominal wall closure methods, 129 patients were classified into the V-Loc closure group and 140 patients were assigned into the conventional layer by layer closure group. In the V-Loc group, abdominal wall closure was performed from the fascia to the skin with a single thread of unidirectional absorbable barbed suture $V-Loc^{TM}$ 90 2-0 using continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time ($40.0{\pm}15.4min$ vs. $44.9{\pm}16.3min$, p=0.013) and abdominal wall cusing continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time losure time ($5.5{\pm}0.9min$ vs. $6.5{\pm}0.8min$, p<0.001). Postoperative incision length was significantly shorter in the V-Loc closure group ($1.1{\pm}0.3cm$ vs. $1.8{\pm}0.4cm$, p<0.001). Postoperative wound pain, time to resume diet, postoperative hospital stay, complications including surgical site infection, or mean patient satisfaction score at one month after hospital discharge was not significantly different between the two groups. Conclusion: In conclusion, unidirectional knotless barbed suture is a safe alternative method for abdominal wall closure after SILA. It can save time while providing comparable cosmesis.

Ex Vivo Raman Spectroscopy Measurement of a Mouse Model of Alzheimer's Disease (라만 기반 치매 모델의 뇌조직 분광 특성 측정)

  • Ko, Kwanhwi;Seo, Younghee;Im, Seongmin;Lee, Hongki;Park, Ji Young;Chang, Won Seok;Kim, Donghyun
    • Korean Journal of Optics and Photonics
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    • v.33 no.6
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    • pp.331-337
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    • 2022
  • Raman spectroscopy is an optical technique that can identify molecules in a label-free manner, and is therefore heavily investigated in various areas ranging from biomedical engineering to materials science. Probe-based Raman spectroscopy can perform minimally invasive chemical analysis, and thus has potential as a real-time diagnostic tool during surgery. In this study, Raman experimentation was calibrated by examining the Raman shifts with respect to the concentrations of chemical substances. Raman signal characteristics, targeted for normal mice and cerebral tissues of the 5xFAD dementia mutant model with accumulated amyloid beta plaques, were measured and analyzed to explore the possibility of diagnosis of Alzheimer's disease. The application to the diagnosis of dementia was cross-validated by measuring Raman signals of amyloid beta. The results suggest the potential of Raman spectroscopy as a diagnostic tool that may be useful in various areas of application.

Regional Lymph Node Dissection as an Additional Treatment Option to Endoscopic Resection for Expanded Indications in Gastric Cancer: a Prospective Cohort Study

  • Seo, Ho Seok;Yoo, Han Mo;Jung, Yoon Ju;Lee, Sung Hak;Park, Jae Myung;Song, Kyo Young;Jung, Eun Sun;Choi, Myung-Gyu;Park, Cho Hyun
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.442-453
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    • 2020
  • Purpose: Expanded indications for endoscopic submucosal dissection (ESD) in early gastric cancer (EGC) remain controversial due to the potential risk of undertreatment after adequate lymph node dissection (LND). Regional LND (RLND) is a novel technique used for limited lymphadenectomy to avoid gastrectomy. This study established the safety and effectiveness of RNLD as an additional treatment option after ESD for expanded indications. Materials and Methods: A total of 69 patients who met the expanded indications for ESD were prospectively enrolled from 2014 to 2017. The tumors were localized using intraoperative esophagogastroduodenoscopy (EGD) before RLND. All patients underwent RLND first, followed by conventional radical gastrectomy with LND. The locations of the preoperative and intraoperative EGD were compared. Pathologic findings of the primary lesion and the RLND status were analyzed. Results: The concordance rates of tumor location between the preoperative and intraoperative EGD were 79.7%, 76.8%, and 63.8% according to the longitudinal, circumferential, and regional locations, respectively. Of the 4 patients (5.7%) with metastatic LNs, 3 were pathologically classified as beyond the expanded indication for ESD and 1 had a single LN metastasis in the regional lymph node. Conclusions: RLND is a safe additional option for the treatment of EGC in patients meeting expanded indications after ESD.

The Effects of the Expansion of Formal Home Care Services for the Elderly on Time Allocation of Family in Korea (노인 재가서비스의 확대가 가족의 생활시간에 미친 영향: 삼중차이 방법의 적용)

  • Lee, Seungho;Byun, Geumsun;Shin, Yumi
    • 한국사회정책
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    • v.23 no.1
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    • pp.227-256
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    • 2016
  • This study examines whether formal home care has led to a reduction in family member's allocation of time to care of elderly and changing the allocation of other time: informal care, market work, leisure, etc. Long-term care for the elderly is not the entire burden of elderly families anymore due to the increasing of the formal home care service for elderly since mid-2000's. This study uses triple difference(DDD) methods for evaluating policy reforms when reforms are equally and nation-wide accessible and analyzes data from the 2004 and 2009 Time Use Survey Data of the National Statistical Office in Korea. The treatment group is composed of the families of the elderly who need care and low- and middle- income family. Controlling for demographic characters, the three-way interaction term has statically significant and negative impact on care time of family members in treatment group statistically significant. The results reveal that the policy changes in elderly home care service affect time allocation of family members with old adults, which decreases caregiving time in a daily life. This result becomes apparent when we limit the case of women. But the level of reduction is not enough to change other kinds of time-informal care, market work, leisure, etc. The results indicate that formal home care for the elderly can reduce the burden of caregiving in families, but only minimally.

Potential Applicability of Local Resection With Prophylactic Left Gastric Artery Basin Dissection for Early-Stage Gastric Cancer in the Upper Third of the Stomach

  • Akashi, Yoshimasa;Ogawa, Koichi;Hisakura, Katsuji;Enomoto, Tsuyoshi;Ohara, Yusuke;Owada, Yohei;Hashimoto, Shinji;Takahashi, Kazuhiro;Shimomura, Osamu;Doi, Manami;Miyazaki, Yoshihiro;Furuya, Kinji;Moue, Shoko;Oda, Tatsuya
    • Journal of Gastric Cancer
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    • v.22 no.3
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    • pp.184-196
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    • 2022
  • Purpose: Total or proximal gastrectomy of the upper-third early gastric cancer (u-EGC) often causes severe post-gastrectomy syndrome, suggesting that these procedures are extremely invasive for patients without pathologically positive lymph node (LN) metastasis. This study aimed to evaluate the clinical applicability of a stomach function-preserving surgery, local resection (LR), with prophylactic left gastric artery (LGA)-basin dissection (LGA-BD). Materials and Methods: The data of patients with u-EGC (pathologically diagnosed as T1) were retrospectively analyzed. Total gastrectomy was performed in 30 patients, proximal gastrectomy in 45, and subtotal gastrectomy in 6; the LN status was evaluated assuming that the patients had already underwent LR + LGA-BD. This procedure was considered feasible in patients without LN metastases or in patients with cancer in the LGA basin. The reproducibility of the results was also evaluated using an external validation dataset. Results: Of the 82 eligible patients, 79 (96.3%) were cured after undergoing LR + LGA-BD, 74 (90.2%) were pathologically negative for LN metastases, and 5 (6.1%) had LN metastases, but these findings were only observed in the LGA basin. Similarly, of the 406 eligible tumors in the validation dataset, 396 (97.5%) were potentially curative. Tumors in the lesser curvature, post-endoscopic resection status, and small tumors (<20 mm) were considered to be stronger indicators of LR + LGA-BD as all subpopulation cases met our feasibility criteria. Conclusions: More than 95% of the patients with u-EGC might be eligible for LR + LGA-BD. This function-preserving procedure may contribute to the development of u-EGC without pathological LN metastases, especially for tumors located at the lesser curvature.

Current Trends in the Treatment of Hallux Valgus: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (무지외반증 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Jaeho;Cho, Byung-Ki;Park, Hyun-Woo;Sung, Ki-Sun;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.4
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    • pp.157-164
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    • 2021
  • Purpose: This study aimed to report the current trends in the management of the hallux valgus (HV) deformity over the last few decades through a survey of the Korean Foot and Ankle Society (KFAS) members. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experience in correction in patients with an HV deformity. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: One hundred and nine (19.8%) of the 550 members responded to the survey. The most common symptom for determining surgical treatment was bunion pain (68.8%), and different surgical techniques were selected according to the following radiological parameters: HV angle 30 to 40 degrees and intermetatarsal angle 15 to 20 degrees. The two procedures most preferred by the respondents were distal chevron osteotomy (55.0%), and proximal chevron osteotomy (21.1%). In an average of 71.6% of respondents, Arkin osteotomy was performed simultaneously during HV surgery. HV accompanied by an overriding deformity of the second toe was most often addressed with a combination of second metatarsal osteotomy and soft tissue rebalancing procedure (35.8%). After HV surgery, the recurrence rate of HV deformity was found to be 12.2% on average and the surgeons who had performed minimally invasive surgery (MIS) for HV comprised 34.9% of the total respondents. Conclusion: This study provides updated information on the current trends in the management of the HV deformity in Korea. Both consensus and variation in the approach to patients with HV were identified by this survey study. Although MIS for HV has increased, it appears the consensus for selecting this method has not yet been established.

Development of Korean NOVA Food Classification and Estimation of Ultra-Processed Food Intake Among Adults: Using 2018 Korea National Health and Nutrition Examination Survey (한국형 NOVA 식품분류체계의 개발 및 한국 성인의 초가공식품 섭취량 추정: 2018년 국민건강영양조사 자료를 활용하여)

  • Hae Jin, Park;Sohyun, Park;Jee Young, Kim
    • Korean Journal of Community Nutrition
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    • v.27 no.6
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    • pp.455-467
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    • 2022
  • Objectives: In this study, we suggest a Korean NOVA food classification that can be applied to food consumption among Korean. Based on this suggestion, the nutritional intake of Korean adults from ultra-processed foods (UPFs) was estimated. Methods: Korean commercial food was categorized based on the NOVA food classification criteria through the Korea Food Code and expert meetings. Then, the nutrient intake status of 6,991 participants in the 2018 National Health and Nutrition Examination Survey was analyzed according to the food processing level. Then, 4,152 adult participants (age 19-65) were divided into quartiles on the basis of their intake of UPFs, and the nutrient intakes from UPFs were compared. Results: Korean NOVA Food Classification defines with priority Group I (Unprocessed/ Minimally processed foods) and Group II (Processed culinary ingredients) foods based on the food cooking or consumption. Then, Group III (Processed foods) and Group IV (UPFs) are classified according to whether the characteristics of the raw materials used are maintained or whether the food was consumed before the 1970s. Our analysis results showed that most of the calories in the diet were consumed by Group I (52.7%), followed by Group IV (29.3%). After categorization of the adult participants into four groups according to their energy consumption from UPFs, we found that the highest consumption group (Q4) was younger and had higher percentage of men than women. The comparative analysis of the consumption of ultra-processed foods by Korean adults revealed that participants of a younger age and men consumed higher energy from UPFs than older participants and women, respectively (P < 0.01). Furthermore, the larger intake of UPFs was associated with an increasing trend for a higher intake of energy, sugar, saturated fat (P for trend < 0.001), total fat (P for trend = 0.021), and sodium (P for trend = 0.005), whereas the intake of carbohydrate, protein, and dietary fiber had a decreasing trend (P for trend < 0.001). Conclusions: With the current increase in the consumption of processed and ultra-processed foods, it is important to carefully consider not only nutrient intake but also the level of food processing.

Species Identification and Labeling Compliance Monitoring of Commercial Shrimp Products Sold in Online Markets of South Korea (국내 온라인 유통 새우 제품의 종판별 및 표시사항 모니터링 연구)

  • Kun Hee Kim;Ji Young Lee;Tae Sun Kang
    • Journal of Food Hygiene and Safety
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    • v.38 no.6
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    • pp.496-507
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    • 2023
  • This study investigated species identification and labeling compliance of 48 shrimp products sold in the Korean online markets. Species identification was conducted using the standard DNA barcoding method, using the cytochrome c oxidase subunit I gene. The obtained sequences were compared with those deposited in the NCBI GenBank and BOLD Systems databases. Additionally, phylogenetic analysis was performed to further verify the identified shrimp species. Consequently, 16 shrimp species were identified, including Penaeus vannamei, Pandalus borealis, Palaemon gravieri, Leptochela gracilis, Penaeus monodon, Pleoticus muelleri, Metapenaeopsis dalei, Euphausia pacifica, Lebbeus groenlandicus, Trachypenaeus curvirostris, Argis lar, Metanephrops thomsoni, Metapenaeopsis barbata, Alpheus japonicus, Penaeus chinensis, and Mierspenaeopsis hardwickii. The most prevalent species was Penaeus vannamei, found in 45.8% of the analyzed products. A significant mislabeling rate of 72.9% was found; however, upon excluding generic names such as shrimp, the mislabeling rate reduced to 10.4%. The mislabeling rate was higher in highly-processed products (89.3%) compared with that in minimally-processed products (50%). No correlation was found between the country of origin and mislabeling rate. The results of this study provide crucial data for future monitoring of shrimp products and improving the labeling of shrimp species in Korea.

Characterizing Multichannel Conduit Signal Properties Using a Ground Penetrating Radar: An FDTD Analysis Approach (FDTD 수치해석을 이용한 다중 관로에 대한 GPR 탐지 신호 특성 분석)

  • Ryu, Hee-Hwan;Bae, Joo-Yeol;Song, Ki-Il;Lee, Sang-Yun
    • Journal of the Korean Geotechnical Society
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    • v.39 no.12
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    • pp.75-91
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    • 2023
  • In this study, we explore the use of ground penetrating radar (GPR) for the nondestructive survey of subsurface conduits, focusing on the challenges posed by multichannel environments. A key concern is the shadow regions created by conduits, which significantly impact survey results. The shadow regions, which are influenced by conduit position and diameter, hinder signal propagation, thereby making detection within these regions challenging. Using finite-difference time-domain numerical analysis, we examined the characteristics of conduit signals, which typically manifest in hyperbolic patterns. Particularly, we investigated three conduit arrangements: horizontal, vertical, and diagonal. Automatic gain control was applied to amplify the signals, enabling the analysis of variations in shadow regions and signal characteristics for each arrangement. In the horizontal arrangement, the proximity of the two conduits resulted in the emergence of a new hyperbolic pattern between the existing conduits. In the vertical arrangement, the lower conduit could be detected using hyperbolic signals on either side, but the detection was challenging when the upper conduit diameter exceeded that of the lower conduit. In the diagonal arrangement, signal characteristics varied based on the position of shadow regions relative to the detection range of the equipment. Asymmetrical signal patterns were observed when the shadow regions fell within the detection range, whereas the signals of the two conduits were minimally impacted when the shadow regions were outside the detection range. This study provides vital insights into accurately detecting and characterizing subsurface multichannel conduits using GPR-a significant contribution to the field of subsurface exploration and management.